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A Respectful Burial After a Pregnancy Loss

September 13, AD2015

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In the controversy over Planned Parenthood doing things with aborted fetuses that people never thought was happening, the discussion of dignity of human remains was part of the big discussion. I was surprised that the large societal conversation didn’t spark a discussion of baby remains in general. I propose we not let this moment pass without elevating the topic of respectful burial for very small babies out of the fray.

The number of abortions in the U.S. each year is about a million, and the number of naturally occurring early pregnancy losses is about 900,000. So we’re naturally losing almost as many as are aborted, yet the topic of how to care for them is so rare.

If you search “fetal burial” or “pregnancy loss burial”, the results you will find are few. Even websites that promote burial for stillborn babies suggest ignoring the ones less than 20 weeks gestation. However, we have all seen enough photos of very tiny babies, and those close to 20 weeks who are obviously very human, and for whom burial should be pursued.

I was really proud that JoAnna Wahlund’s article on burying her miscarried babies was in the top 10 of one of my searches. She did a great job of giving resources for the miscarriage process, and how they as parents were able to bury their babies given the particular challenges and circumstances they confronted them with each time.

Both JoAnna and I have started the discussion here on this topic, but there are many aspects of this issue that have not yet been explained and discussed. Based on the high need for this service and the low volume of available information, I plan to delve deeper into the topic. This column will deal with ways that hospitals can provide burial, and then a follow up article that will explain how parents and community members can create burial programs from outside the walls of hospitals.

Authors and mothers who commented on JoAnna’s article made an important point. We all recognize that women/parents do the best they can in their circumstances and God loves and cares for these babies – it’s crucial that we be compassionate for ourselves and others, if we didn’t bury our babies in the past, as hospitals historically did not make this process easy for parents. The baby I lost at 9 week gestation went to a landfill and at the time I was physically and emotionally too weak to fight the status quo.

What Options Are Available Now

Traditional Funeral Home care is set up to care for adults, less for children, less for babies but certainly not for very tiny babies. Burying tiny babies one at a time is expensive, requires a lot of space and is quite labor intensive. In my small city, there are at least 250 early losses that go through our Histology lab each year. If every family felt compelled to bury their baby (something that would be a good thing) the resources expended on 250 burials would be massive.

Traditional cremation can be difficult for very tiny babies – they are composed of so much water with cartilage rather than bone. Depending on the gestational age, the ashes can nearly evaporate completely leaving the family with nothing after the process. Catholic teaching is that ashes must be interred so the process can still be involved and expensive.

In some places, it is legal to have “private land” burials and they can be a wonderful solution. However, some people don’t own the land they live on, their home may be transient or the land where they live inappropriate for a burial.

There are times when Funeral Homes can donate their services, but if burying all miscarried babies became commonplace, local businesses could not afford to give away large amounts of goods and services. Free services also can’t be counted on in all circumstances. I have known it to happen, but I have also known of families receiving quotes of nearly $1,000-3,000 to bury a tiny baby.

Why Group Burial Is A Respectful Burial

The program I run through my secular city hospital makes the offer to women to provide free respectful burial to any pregnancy loss that occurs before birth. Very early losses from D&C or ectopic surgeries can be included as well as bigger babies all the way to term stillborn babies.

The babies are held at the hospital and once a quarter are individually bundled (all babies are bathed, dressed, put in a handmade blanket and then bundled with an outer layer which has identification on it. They are casketed in a large infant casket and buried at a cemetery. I have had people get nervous about the co-casketing. But I console them by describing the process like eggs in an egg carton. They aren’t being disrespectful to one another by their presence. They are using their space well.

A licensed Funeral Home takes them directly to the cemetery where there is a spot already prepared. The burial is completed and when the families come for a service the next day, they see a section of freshly disturbed earth. Each brings a bouquet of fresh flowers and we lay the flowers on the ground like a blanket. Most families take photos of themselves at the site.

We have volunteer musicians who play the harp. Most recently we have had some very young musicians. I think the image of children playing music for babies is lovely. The music is followed by a local Pastor or Priest giving a reflection then the names of each baby are read aloud and a bell is rung for each one. Families are welcome to have private rituals there at other times, so if the memorial doesn’t satisfy their need they can add to it.

Families can ask for special things to be included with their babies. Sometime they are all bundled in a blanket made by a grandma. Sometimes siblings draw pictures. Mementos included have been everything from religious medals to stickers, photos and even a dollar bill to buy ice cream in heaven.

The centrality of a single burial area helps when families have more than one loss. The 487 babies buried in our spot already include many siblings and cousins that the families can visit all in the same place. The shared experience of people coming together in grief is so powerful – the rich and the poor, babies of prominent families and unnamed babies have equal standing and importance.

The Funeral Home which does the burial donates the service because they know that they can plan on 4 burials a year and families have something they can count on rather than needy lost sad families trickling into their office one at a time.

Not a Religious Hospital – Why Do We Do All This Work?

Some families bury out of a sense of religious obligation, some not. We have come to realize that moms heal faster and better if they have the option to bury their baby. It’s really mental healthcare for their future. I have had women tell me that the night after they learned their baby died, they laid awake all night worried of what would happen to the baby’s body.

In fact, The American Journal of Maternal Child Nursing published an article on this topic which would be helpful for the Hospital setting.

I had one woman who was about to undergo a surgical procedure to remove a baby who had died; she had no money and was terrified of how she would feel after the procedure if she couldn’t provide a burial for the baby. The mom said that she was handed a form that asked what disposition she chose for her baby and she cried out to God in her heart begging Him to give her an answer. At that instant her phone rang and it was me asking if she wanted me to care for the baby. She burst into tears. I was humbled to be used in such a helpful way.

Based in the system we have developed, we can bury about 20 babies for the price that a family would be charged to bury one. Whether cities or families, funds are finite. If we can spend a small amount that prevents parents from spending their food money on burial, we have done a service for all. They are free to choose among a number of options but for many, this is the only option they can afford and it blesses them greatly.

Hospital programs vary widely, each designed with a different set of resources and demands. These programs don’t solve every challenge, but can fulfill most needs for early loss.

Photography: See our Photographers page.

About the Author:

Tammy Ruiz Ziegler has been a Nurse for 30 years and spent most of her career in Neonatal Intensive Care. For 10 years, she has been a Perinatal Bereavement Coordinator - caring for women and families suffering miscarriage, stillbirth, neonatal death and SIDS. Part of her work involves assisting parents in preparing for births when the baby has received the diagnosis of a life limiting condition (often called "Perinatal Hospice"). In addition to her Nursing education, she studied (but did not become certified in) Clinical Pastoral Education at a Catholic Hospital in the midwest. She has been on EWTN and speaks regularly to Physicians & Nurses on the topic of perinatal loss care. Her work has been translated into Polish, Spanish, Czech, French, Italian & Japanese. Her career was both fragmented and enhanced by having 14 different jobs because of moves for her husband who was an active duty Officer in the USMC. She has 3 quasi-adult children and one super-cute grandchild. A convert to the Catholic Church, she was widowed after 26 years of marriage but recently married a man she met when they were both children.

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